Summer Camp Contract

AFTER SCHOOL KARATE ACADEMY

    STUDENT NAME

    DATE OF BIRTH & GRADE for 2017-2018

    Address:

    City:

    St:

    Zip:

    PARENT/GUARDIAN NAME

    PHONE # (HOME/CELL)

    PHONE # (WORK)

    EMAIL ADDRESS (REQUIRED)

    EMERGENCY CONTACT





    Registration Fee (per child)

    X $100=

    (TOTAL DUE) non-refundable (includes 1 camp shirt)

    Snack Account (per week)

    X $10=

    (TOTAL DUE per week)

    CAMP SHIRT ORDER

    Size

    (Child Small- Adult Large)

    Quantity

    Number of Shirts

    X

    $10=

    (TOTAL DUE)

    Credit Card #

    EXP:

    By providing my account information I hereby agree to authorize Alpha & Omega After School Karate Academy to charge my card for summer camp tuition and service fees.

    Cardholder’s Signature

    Date:

    Tuition fee {Six Flags Fee -$35/Season Pass(not included in Field Trip fees)}
    Plan A 8-10 weeks (per child per week $190 (includes Field Trip fee)
    Plan B 4-7 weeks (per child per week $205 (includes Field Trip fee)
    Plan C 1-3 weeks (per child per week $220 (includes Field Trip fee)

    Put initials in boxes of the weeks you wish to attend

    6/18/2018

    6/25/2018

    7/2/2018

    7/9/2018

    7/16/2018

    7/23/2018

    7/30/2018

    8/6/2018

    8/13/2018

    8/20/2018

    8/27/2018